Please treat me with metoclopramide

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Hypertrophic pyloric stenosis secondary to peptic ulcer disease is uncommon.
• Clinical presentation often includes vomiting, nausea, early satiety, weight loss, and epigastric pain.

Observation:

• A 43-year-old male presented with persistent vomiting, initially refusing diagnostic procedures.
• Physical examination was inconclusive due to the difficulty in palpating the pyloric mass.

Findings:

• Barium meal examination revealed severe pyloric stenosis.
• Surgical treatment involved vagotomy and enteroanastomosis.
• Histopathological analysis of the resected gastric segment confirmed the absence of malignancy.

Implications:

• This case highlights the importance of thorough investigation in patients with persistent gastrointestinal symptoms, even when physical findings are subtle.
• Early diagnosis and appropriate surgical management are crucial for favorable outcomes in rare cases of peptic ulcer-induced pyloric stenosis.